Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, UK.
Int J Geriatr Psychiatry. 2011 Oct;26(10):991-9. doi: 10.1002/gps.2640. Epub 2010 Dec 28.
To review the rapidly expanding literature of amyloid PET imaging with particular attention to Pittsburgh compound-B (PIB) in Alzheimer's disease (AD), dementia with Lewy bodies (DLB), fronto-temporal dementia (FTD), mild cognitive impairment (MCI) and cognitively normal volunteers.
Literature searches were performed using Medline up to February 2010. Individual articles were then examined for additional references not revealed by automated searches. This yielded 79 articles whose abstracts were read by the authors to select key papers.
Amyloid deposition assessed using PIB-PET is significantly elevated in AD and DLB compared to controls and those with FTD. In MCI, uptake is often intermediate between AD and normal ageing, and excessive amyloid burden in non-demented individuals with MCI are likely to represent high-risk cases. Amyloid deposition appears to be an early event, and as dementia progresses clinical decline seems to be more associated with neurodegeneration than amyloid burden.
PIB-PET imaging is a sensitive and specific marker for underlying Aβ amyloid deposition and represents an important investigative tool for examining the relationship between amyloid burden, clinical symptoms and structural and functional changes in dementia. Amyloid imaging may also be useful for selecting patients for anti-amyloid therapies. However, studies have identified PIB-positive cases in otherwise healthy older individuals (10-30%), limiting diagnostic specificity. Development of biomarkers for investigating other aspects of dementia pathology, i.e. soluble Aβ, tau, synuclein and brain inflammation would further inform our understanding and assist in studying disease-modifying and preventive treatments in dementia.
综述淀粉样蛋白 PET 成像的快速发展，尤其关注匹兹堡化合物-B（PIB）在阿尔茨海默病（AD）、路易体痴呆（DLB）、额颞叶痴呆（FTD）、轻度认知障碍（MCI）和认知正常志愿者中的应用。
使用 Medline 进行文献检索，截至 2010 年 2 月。然后，逐个检查文章以获取自动搜索未揭示的其他参考文献。这产生了 79 篇文章，其摘要由作者阅读以选择关键论文。
与对照组和 FTD 患者相比，AD 和 DLB 患者使用 PIB-PET 评估的淀粉样蛋白沉积明显升高。在 MCI 中，摄取量通常介于 AD 和正常老化之间，而 MCI 中非痴呆个体中过多的淀粉样蛋白负荷可能代表高风险病例。淀粉样蛋白沉积似乎是一个早期事件，随着痴呆的进展，临床衰退似乎与神经退行性变而不是淀粉样蛋白负荷更相关。
PIB-PET 成像对潜在的 Aβ淀粉样蛋白沉积是一种敏感和特异性标志物，是检查淀粉样蛋白负荷、临床症状以及痴呆症中结构和功能变化之间关系的重要研究工具。淀粉样蛋白成像也可能有助于选择接受抗淀粉样蛋白治疗的患者。然而，研究已经在其他健康的老年人中发现了 PIB 阳性病例（10-30%），这限制了诊断的特异性。开发用于研究痴呆症病理学其他方面的生物标志物，即可溶性 Aβ、tau、突触核蛋白和脑炎症，将进一步帮助我们理解并协助研究痴呆症的疾病修饰和预防治疗。
